House Democrats set July 31 deadline for health system reform bill

Washington -- House Democratic leaders called for a House floor vote on national health system reform legislation before the August congressional recess. But Republicans and a group of fiscally conservative Democrats say they want a larger role in writing the bill.

"Our legislation will be on the floor by the end of July -- I am quite certain -- and that is really cause for celebration for the American people," House Speaker Nancy Pelosi (D, Calif.) said May 13 at a joint news conference with President Obama and the chairs of the three House committees with jurisdiction over health care.

Pelosi's announcement backs up a similar commitment made by the three House committee chairs in March. The House panels are trying to match the brisk pace set by Senate Finance Committee Chair Max Baucus (D, Mont.), who is writing a national health reform bill with the committee's highest-ranking Republican, Sen. Charles Grassley (Iowa).

But some House members were unhappy with how the chairs of the House Energy and Commerce, Education and Labor, and Ways and Means Committees were conducting the legislative process.

The Blue Dog Coalition, a group of 51 conservative Democrats, on May 12 asked Pelosi and the committee chairs for a larger role in drafting a House health reform measure. The letter says the Senate Finance Committee has had a much more open, inclusive legislative process than the relevant House committees. "As we move forward, moderate voices should have a key role in this debate, and we must never lose sight of how these reforms will impact small businesses and working families across this country," said Rep. Mike Ross (D, Ark.), chair of the Blue Dog Health Care Task Force.

A group of GOP House members working on health reform also asked House committee chairs to listen to their ideas. Rep. Roy Blunt (R, Mo.), chair of the 21-member House Health Care Solutions Group, said May 14 they have been reaching out to House committee chairs and the Blue Dog Coalition in hopes of having a more bipartisan process in crafting legislation. But he said he had not heard back from Democratic leaders in the House.

Matthew Beck, Democratic spokesman for the House Ways and Means Committee, said committee Chair Charles Rangel (D, N.Y.) has had several conversations this year with Rep. Dave Camp (Mich.), the panel's highest-ranking Republican and a member of the GOP health group. "We have been, and continue to be, inclusive of all members and their views as we shape legislation to reform America's health care system to control costs and ensure that everyone has access to care that meets their needs," Beck said.

A House Energy and Commerce Committee Republican aide, speaking on condition of anonymity in order to discuss the issue openly, said May 15 that Energy and Commerce Chair Henry Waxman (D, Calif.) has not included Republicans in legislative discussions on health reform.

In the meantime, the Republican Health Care Solutions Group is making progress on crafting its own plan for national health reform, Blunt said. Group members said they are skeptical of the need for a national public health insurance plan to compete with private plans because the government shouldn't both regulate the health insurance market and participate in it.

"It makes the referee and the player the same person," said Rep. Tom Price, MD (Ga.). Blunt said the group prefers a model like the Medicare prescription drug benefit, in which private plans compete for enrollees on a level playing field.

The group is not likely to weigh in on Medicare pay for physicians. Two GOP Health Care Solutions members -- Reps. Phil Gingrey, MD (Ga.), and Mike Burgess, MD (Texas) -- said May 14 that their group does not plan to offer a specific fix for the impending 21.5% cut to Medicare physician pay. "We don't really want to focus so much on the doctors' income," Dr. Gingrey said.

Dr. Burgess planned in late May to release an updated version of a bill he sponsored last year that would base Medicare physician payment on the Medicare Economic Index, a measure of the costs of running a physician practice.

Dr. Gingrey also favors basing Medicare physician fees on the MEI, plus adding other physician payment incentives. "You're going to have to pay more for cognitive and for consultation and that sort of thing. Or maybe managing a medical home or managing wellness and not just treating illness."